Characterizing alcohol dependence: transitions during young and middle adulthood.

Community and high-risk sample studies suggest that alcohol dependence is relatively stable and chronic. By contrast, epidemiological studies demonstrate a strong age-graded decline whereby alcohol dependence tends to peak in early adulthood and declines thereafter. The authors identified the latent trajectory structure of past-year alcohol dependence to investigate (a) whether the syndrome is characterized by symptom profiles and (b) the extent to which the syndrome is stable and persistent. Data from current drinkers (N = 4,003) in the National Longitudinal Survey of Youth were analyzed across two waves: 1989 (ages 24-32 years) and 1994 (ages 29-37 years). Three classes of alcohol dependence were observed; symptom endorsement probabilities increased across successively severe classes. Latent transition analyses showed high rates of stability, supporting alcohol dependence as a relatively chronic condition. Although there was evidence of progression to more severe dependence, there was greater syndrome remission. Trajectory classes and transition probabilities were generalizable across race and sex and, to a lesser extent, age cohort and family history of alcoholism.